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Generic Name: ziv-aflibercept (ZIV a FLIB er sept)
Brand Name: Zaltrap

What is ziv-aflibercept?

Ziv-aflibercept is made from a human antibody fragment. It works by keeping new blood vessels from forming in a fast-growing tumor.

Ziv-aflibercept is used in combination with other medications to treat colorectal cancer.

Ziv-aflibercept is usually given after other medications have been tried without successful treatment.

Ziv-aflibercept may also be used for purposes not listed in this medication guide.

What is the most important information I should know about ziv-aflibercept?

You should not use this medicine if you have severe bleeding or uncontrolled hypertension (high blood pressure).

If you need surgery, tell the surgeon ahead of time that you are using ziv-aflibercept.

Ziv-aflibercept may cause serious and sometimes fatal bleeding. Call your doctor at once if you have any signs of unusual bleeding, including easy bruising, bloody stools, coughing up blood, or feeling light-headed or short of breath.

What should I discuss with my healthcare provider before receiving ziv-aflibercept?

You should not be treated with ziv-aflibercept if you are allergic to it, or if you have:

  • severe bleeding; or

  • severe or uncontrolled high blood pressure.

To make sure ziv-aflibercept is safe for you, tell your doctor if you have:

  • high blood pressure;

  • open sores or skin wounds; or

  • if you have had surgery or dental work within the past 4 weeks.

It is not known whether ziv-aflibercept will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

Use birth control to prevent pregnancy while you are receiving ziv-aflibercept, and for at least 3 months after your treatment ends, whether you are a man or a woman.

This medication may affect fertility (your ability to have children), whether you are a man or a woman.

It is not known whether ziv-aflibercept passes into breast milk or if it could harm a nursing baby. You should not breast-feed while you are using ziv-aflibercept.

How is ziv-aflibercept given?

Ziv-aflibercept is injected into a vein through an IV. A healthcare provider will give you this injection.

Ziv-aflibercept is usually given every other week. This medicine must be given slowly, and the IV infusion can take at least 1 hour to complete.

Ziv-aflibercept can cause problems with wound healing, which could result in bleeding or infection. If you need to have any type of surgery, you will need to stop receiving ziv-aflibercept at least 4 weeks ahead of time. Do not start using the medicine for at least 4 weeks after surgery, or until your surgical incision heals.

While using ziv-aflibercept, you may need frequent blood tests. Your blood pressure will also need to be checked often.

What happens if I miss a dose?

Call your doctor for instructions if you miss an appointment for your ziv-aflibercept injection.

What happens if I overdose?

Since this medication is given by a healthcare professional in a medical setting, an overdose is unlikely to occur.

What should I avoid while receiving ziv-aflibercept?

This medicine can pass into body fluids (urine, feces, vomit). For at least 48 hours after you receive a dose, avoid allowing your body fluids to come into contact with your hands or other surfaces. Caregivers should wear rubber gloves while cleaning up a patient's body fluids, handling contaminated trash or laundry or changing diapers. Wash hands before and after removing gloves. Wash soiled clothing and linens separately from other laundry.

Ziv-aflibercept side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Ziv-aflibercept can make it easier for you to bleed. Call your doctor or seek emergency medical attention if you have:

  • easy bruising, unusual bleeding (nose, mouth, vagina, rectum), or any bleeding that will not stop;

  • signs of bleeding in your digestive tract--severe stomach pain, bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds; or

  • signs of bleeding in the brain--sudden numbness or weakness (especially on one side of the body), sudden severe headache, problems with speech or balance.

Call your doctor at once if you have:

  • any wound that will not heal;

  • severe or ongoing vomiting or diarrhea;

  • chest pain;

  • confusion, change in mental status, vision loss, seizure (convulsions);

  • signs of infection--fever, chills, flu-like symptoms, swollen gums, mouth sores, skin sores, rapid heart rate, pale skin, feeling light-headed, pain or burning when you urinate;

  • dangerously high blood pressure--severe headache, blurred vision, pounding in your neck or ears, nosebleed, anxiety;

  • dehydration symptoms--feeling very thirsty or hot, being unable to urinate, heavy sweating, or hot and dry skin;

  • signs of a kidney disorder--puffy eyes, swelling in your ankles or feet, weight gain, urine that looks foamy; or

  • signs of a fistula (abnormal passageway) in your lower body--rectal pain, foul-smelling vaginal discharge, pain or swelling in your lower stomach, problems with urination or bowel movements.

Older adults may be more likely to have severe diarrhea or get dehydrated while receiving ziv-aflibercept.

Common side effects may include:

  • increased blood pressure;

  • nosebleed;

  • loss of appetite, stomach pain, diarrhea;

  • headache, feeling tired;

  • weight loss; or

  • abnormal kidney or liver function tests.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Ziv-aflibercept dosing information

Usual Adult Dose for Colorectal Cancer:

4 mg per kg as an intravenous (IV) infusion over 1 hour every two weeks until disease progression or unacceptable toxicity. Administer ziv-aflibercept prior to any component of the FOLFIRI regimen on the day of treatment

What other drugs will affect ziv-aflibercept?

Other drugs may interact with ziv-aflibercept, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.

Where can I get more information?

  • Your pharmacist can provide more information about ziv-aflibercept.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 1.03.

Date modified: October 14, 2016
Last reviewed: January 07, 2016